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General Health & Fitness
Health & Wellness
Evidence-Based Guideline for the management of osteoporosis in men
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<blockquote data-quote="madman" data-source="post: 277759" data-attributes="member: 13851"><p><strong>Summary of recommendations and guidelines</strong></p><p></p><p><em>Here we summarize the recommendations of the working group for the diagnosis, screening, assessment and treatment of men with osteoporosis. <strong>The statements supported by the working group are itemised below and detailed ratings are presented in Supplementary Table 1</strong>.Statements were graded ‘weak recommendations’ if 75% of voters selected either ‘strong do’ or ‘weak do’, and were graded as ‘strong recommendations’ if 75% of voters selected ‘strong do’</em></p><p><em></em></p><p><em></em></p><p><em></em></p><p><em></em></p><p><em><strong>• A female reference database should be used for the densitometric diagnosis of osteoporosis in men (strong recommendation).</strong></em></p><p></p><p><strong><em>• FRAX is the appropriate tool for the assessment of fracture risk and as the basis for setting intervention thresholds in men with osteoporosis (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• FRAX-based intervention thresholds should be age dependent in men with osteoporosis (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Trabecular bone score, used with BMD and FRAX probability, provides useful information for fracture risk assessment in men (weak recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• All men with a prior fragility fracture should be considered for treatment with anti-osteoporosis medications (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• The anti-osteoporosis treatment regimen in men should be adapted to an individual’s baseline fracture risk (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Vitamin D and calcium repletion should be ensured in all men above the age of 65 years (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Oral bisphosphonates (alendronate or risedronate) are first-line treatments for men at a high risk of fracture (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Denosumab or zoledronate are second-line treatments for men at a high risk of fracture (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• A sequential therapy starting with a bone-forming agent followed by an anti-resorptive agent should be considered for men at a very high risk of fracture (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Biochemical markers of bone turnover are the appropriate tool to assess adherence to anti-resorptive therapy in men (weak recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Bone-forming agents, when given as first-line treatment in men at a very high risk of fracture, should be used in accordance with the recommendations of the regulatory authorities (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Physical exercise and a balanced diet should be recommended to all men with osteoporosis (strong recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Serum total testosterone should be assessed, as part of the pre-treatment assessment of men with osteoporosis (weak recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Appropriate hormone replacement therapy should be considered in men with low levels of total or free serum testosterone (weak recommendation).</em></strong></p><p><strong><em></em></strong></p><p><strong><em>• Based on available BMD data, abaloparatide is considered an appropriate first-line treatment for men with osteoporosis at avery high risk of osteoporotic fracture (weak recommendation).</em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 277759, member: 13851"] [B]Summary of recommendations and guidelines[/B] [I]Here we summarize the recommendations of the working group for the diagnosis, screening, assessment and treatment of men with osteoporosis. [B]The statements supported by the working group are itemised below and detailed ratings are presented in Supplementary Table 1[/B].Statements were graded ‘weak recommendations’ if 75% of voters selected either ‘strong do’ or ‘weak do’, and were graded as ‘strong recommendations’ if 75% of voters selected ‘strong do’ [B]• A female reference database should be used for the densitometric diagnosis of osteoporosis in men (strong recommendation).[/B][/I] [B][I]• FRAX is the appropriate tool for the assessment of fracture risk and as the basis for setting intervention thresholds in men with osteoporosis (strong recommendation). • FRAX-based intervention thresholds should be age dependent in men with osteoporosis (strong recommendation). • Trabecular bone score, used with BMD and FRAX probability, provides useful information for fracture risk assessment in men (weak recommendation). • All men with a prior fragility fracture should be considered for treatment with anti-osteoporosis medications (strong recommendation). • The anti-osteoporosis treatment regimen in men should be adapted to an individual’s baseline fracture risk (strong recommendation). • Vitamin D and calcium repletion should be ensured in all men above the age of 65 years (strong recommendation). • Oral bisphosphonates (alendronate or risedronate) are first-line treatments for men at a high risk of fracture (strong recommendation). • Denosumab or zoledronate are second-line treatments for men at a high risk of fracture (strong recommendation). • A sequential therapy starting with a bone-forming agent followed by an anti-resorptive agent should be considered for men at a very high risk of fracture (strong recommendation). • Biochemical markers of bone turnover are the appropriate tool to assess adherence to anti-resorptive therapy in men (weak recommendation). • Bone-forming agents, when given as first-line treatment in men at a very high risk of fracture, should be used in accordance with the recommendations of the regulatory authorities (strong recommendation). • Physical exercise and a balanced diet should be recommended to all men with osteoporosis (strong recommendation). • Serum total testosterone should be assessed, as part of the pre-treatment assessment of men with osteoporosis (weak recommendation). • Appropriate hormone replacement therapy should be considered in men with low levels of total or free serum testosterone (weak recommendation). • Based on available BMD data, abaloparatide is considered an appropriate first-line treatment for men with osteoporosis at avery high risk of osteoporotic fracture (weak recommendation).[/I][/B] [/QUOTE]
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General Health & Fitness
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Evidence-Based Guideline for the management of osteoporosis in men
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